Alaska News

Esther Cepeda: Preemies cost a lot - so let's find ways to give them nine months

CHICAGO -- Tim Armstrong is the corporate villain du jour for singling out the high costs of caring for sick babies. But the AOL chief executive did America's premature infants a big favor by bringing their pint-sized pains to national attention.

Trust me, no one thinks nearly enough about preemies.

Not modern medicine -- it has advanced in treating neonates but not in preventing premature births. And not mothers-to-be -- even the ones who obsess about every moment of their pregnancy in the hopes of having a healthy baby.

More on that in a moment.

First, let's recap.

During a conference call with employees, Armstrong is reported to have blamed changes to the company's retirement savings plan on higher medical costs associated with the Affordable Care Act and on the 2012 births of two "distressed babies" of AOL employees who supposedly had cost "a million dollars each" to care for.

Armstrong later apologized and even reversed his decision on the 401(k) match, but not before the novelist Deanna Fei -- the wife of an AOL employee who recognized her family's situation in Armstrong's comments -- went public with her humiliation. She said Armstrong's mention of her baby's struggle was "a violation of my family's privacy" and "a complete dehumanization of my daughter."

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Good for her, she is a great champion for preemies.

Writing in Slate magazine, Fei described the lead-up to her daughter's birth: "There was nothing high-risk about my pregnancy. I never had a single risk factor for a preterm birth, let alone one as extreme as this one. Until the morning I woke up in labor, every exam indicated that our daughter was perfectly healthy."

Welcome to the club, momma. It's a terrible sisterhood to belong to and -- adding insult to injury -- a lot of people mistakenly believe that mothers who have preemies are poor, uneducated and unhealthy and could (and should) have prevented it.

Not so.

Though it is statistically accurate to say that minority women tend to deliver preterm babies more often than whites, "premature birth can happen to anyone," the Mayo Clinic notes. "In fact, many women who have a premature birth have no known risk factors."

I've had three babies, each one born preterm. Previous premature delivery is a risk factor for a preemie birth, so the second and third early arrivals were less of a shock. But that first infant set me straight on all the preconceived notions of what causes premature birth.

I was middle class, college-educated, healthy, of normal weight, and I didn't drink or smoke. I ate well, exercised throughout my pregnancies and, it goes without saying, had excellent health care that included a thorough birthing class in which my husband and I learned about all the emergency protocols and birthing tools that are used to deliver a distressed baby.

Nothing had prepared us to actually need to understand the medical jargon and recognize all the equipment a struggling preemie needs just to breathe and eat.

Yet, though we live in one of the richest countries in the world, we were just one of a very large crowd of families in the United States who very unexpectedly didn't have the storybook birth they'd dreamed of.

According to the World Health Organization, 12 percent (500,000) of all babies in the U.S. are born before their due date -- a rate far higher than in Europe, Canada, Australia or Japan. Put another way: preemies represent about one in eight live births in this country.

And the ones who survive do so at a ridiculous expense. According to the March of Dimes, preterm births in the United States cost more than $26 billion annually. In 2009, the cost to employers was more than $12 billion in excess health care expenses through the first year of life.

By all means, let's talk about preemies: Their multibillion-dollar annual cost, how their gestation could eventually be prolonged, how their early arrival sets them up for a lifetime of catching up to peers, and how pregnant women can be effectively targeted for preventive measures.

As a boss, Armstrong might care primarily about the employer costs of an unexpectedly premature baby. But as a leader he can redeem himself from his gaffe by joining the rest of us in pushing for medical breakthroughs that will spare families the awful pain of delivering their babies too soon.

Esther Cepeda is a columnist for The Washington Post.

By ESTHER CEPEDA

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